National Provider Identifier [NPI]: |
1508033226 |
Last Name Of The Provider |
ALAPISHVILI |
First Name Of The Provider |
NINO |
Middle Initial Of The Provider |
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Credentials Of The Provider |
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Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1445 N HUNT CLUB RD STE 201 |
Street Address 2 Of The Provider |
|
City Of The Provider |
GURNEE |
Zip Code Of The Provider |
600312603 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
2348 |
Number Of Medicare Beneficiaries |
445 |
Total Submitted Charge Amount |
515334 |
Total Medicare Allowed Amount |
266959.51 |
Total Medicare Payment Amount |
206773.06 |
Total Medicare Standardized Payment Amount |
196666.51 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
144 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
112 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
204 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
247 |
Number Of Black or African American Beneficiaries |
111 |
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
69 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
188 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
62 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
4.6731 |